Psychological&behavioralconsultantspa
NPI #1811026123 in White Bear Lake, Minnesota
Provider Information
- NPI Number
- 1811026123
- Entity Type
- Organization
- Organization Name
- Psychological&behavioralconsultantspa
- Primary Specialty
- Psychologist
- Enumeration Date
- Mar 4, 2007
- Last Updated
- Feb 24, 2013
Practice Location
- Address
- 2186 3RD ST
- Address 2
- SUITE 105
- City
- White Bear Lake
- State
- Minnesota
- ZIP Code
- 55110-3263
- Phone
- (651) 227-8880
Authorized Official
- Name
- DR. W S BALCERZAK, PH.D.
- Title
- CEO
- Phone
- (651) 227-8880
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychologist |
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